Provider Demographics
NPI:1841435955
Name:MONTGOMERY DRUG COMPANY
Entity type:Organization
Organization Name:MONTGOMERY DRUG COMPANY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:BLAKE
Authorized Official - Last Name:VINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-386-3501
Mailing Address - Street 1:185 ASHTON PLAZA ST
Mailing Address - Street 2:
Mailing Address - City:MILLBROOK
Mailing Address - State:AL
Mailing Address - Zip Code:36054-1880
Mailing Address - Country:US
Mailing Address - Phone:334-386-3501
Mailing Address - Fax:334-386-3502
Practice Address - Street 1:185 ASHTON PLAZA ST
Practice Address - Street 2:
Practice Address - City:MILLBROOK
Practice Address - State:AL
Practice Address - Zip Code:36054-1880
Practice Address - Country:US
Practice Address - Phone:334-386-3501
Practice Address - Fax:334-386-3502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-04
Last Update Date:2008-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1132233336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy